Individual
STACEY YODER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
9200 CALUMET AVE, SUITE N100, MUNSTER, IN 46321-2885
(219) 513-0500
Mailing address
7929 W 91ST PL, CROWN POINT, IN 46307-7439
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008777A
IN
225100000X
Physical Therapist
070.015368
IL
Other
Enumeration date
02/11/2007
Last updated
05/11/2008
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